Therapeutic Adherence: Missing Piece to Treat Chronic Diseases

The WHO estimates that if every patient with a chronic disease followed his or her treatment to the letter, 200,000 deaths in Europe could be avoided every year.

Adherence refers to the consistency between the doctor’s recommendations and the patient’s behavior. From a medical point of view, a patient is considered nonadherent if he/she takes less than 80% of their treatment.

According to the WHO, improving therapeutic adherence would have a positive impact on human health, even greater than the development of new therapies. Indeed, despite the progress made by medical science field recently, there is still very little control in chronic diseases, that is largely due to poor adherence.

The impact of non-adherence is also substantial for healthcare systems. With less than 50% of patients correctly following their monthly prescribed treatment, the extra cost is colossal: 25% of drugs prescribed by doctors are never used by patients, resulting in an additional cost of around 120 billion euros in Europe!

The challenge here is twofold: -

improve patients’ life expectancy and quality of life,

-be more efficient in terms of healthcare expenditure by raising public authorities’ awareness of this major global issue.

Understanding The Reasons For Poor Therapeutic Adherence

By understanding why patients are not adherent, we would be able to offer more personalized solutions and improve adherence. To identify all these factors, Real World Evidence (RWE) studies provide us with information that complements clinical trial data, such as how well patients follow their treatment and what obstacles they face in their compliance. These are key data to define our strategic orientations so that we can deliver solutions that are increasingly adapted to each patient.

There are many patient-related factors that can explain this phenomenon: a patient’s belief in the need for treatment, as well as the discrepancy between their perception of treatment benefits and risks. Many patients also report that they do not always fully understand their prescriptions. The more complex the treatment, the more difficult it is for the patient to measure its benefit.

The causes identified include also demographic factors: the elderly are more prone to chronic illnesses and to forgetting to take their medication. As a result, the aging of the population leads to a logical increase in therapeutic non-adherence.

Lastly, economic factors play an important role in countries where access to healthcare is mainly provided through private channels.

What Solutions Should Be Introduced?

At Servier, we seek to address all factors that can improve adherence. Furthermore, we have incorporated this dimension into the entire life cycle of our medicines, from R&D to medical communication. This year, within our Group, over 100 projects involving therapeutic adherence worldwide have been jointly developed with patient associations.

We are particularly focused on three key areas:

-Incremental innovation to simplify treatment administration and monitoring

Fixed combinations, “Single Pill Combinations” (SPCs), combine several molecules into a single tablet to simplify treatment, and therefore patients’ daily lives. They are recognized as a useful solution for improving adherence and their value was recently confirmed by the WHO, which for the first time included fixed-dose combinations in primary and secondary preventive treatment at its 24th Expert Committee on the Selection and Use of Essential Medicines.

-Digital Innovation as a “Beyond The Pill” Remedy

Digital applications are another important factor in promoting patient compliance. To this end, we are working with external partners to develop “digital companions,” applications or monitoring tools that accompany patients throughout their treatment from diagnosis to medical follow-up.

-Therapeutic Patient Education (TPE)

The TPE approach aims to empower patients to take an active role in their own treatment by strengthening their knowledge of the subject. It includes psychological support groups, experience sharing, screening campaigns etc. Here again, our teams work alongside patient associations. A notable example includes our over five-year collaboration with the “Because I say so” and “Take your medicine” campaigns.

As a leading global healthcare provider in the field of chronic diseases, and thanks to our resolutely patientcentric approach, treatment adherence is fully integrated to our strategy. Therefore, the challenge for Servier between now and 2030 is to be able to offer patients a complete range of therapeutic solutions that can satisfy all patients, whatever their individual needs.

We each have a role to play in improving and reinforcing therapeutic adherence. While adherence is a strategic issue for Servier, we also want public authorities to share this vision. Together, we have the means to not only implement global action plans, but also to evaluate and financially enhance available tools and therapeutic patient education programs. Private and public organizations must work together towards a shared vision to accelerate innovations for the benefit of all.